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Comment by clairity | Hacker News Reader

> "Who said masks don't work? What I recall people saying is:

> * most masks provide marginal protection to the wearer

> * the masks that provide effective protection should be saved for those in situations where they need them (and can be knowledgeably used)

> * most people probably don't need those masks"

yup, moreover, masks are marginal on top of other measures, most notably distancing. masks can make a difference if you're in a situation where you can't distance when face-to-face in proximity of strangers for more than a short time. distancing requires less "expertise" and cognizance as well, so is a better principal measure all around.

that's a more nuanced message than "masks don't work". the opposing "wear masks at all times" is similarly dogmatic and incorrect.

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It may be similarly dogmatic, but there are degrees of correctness, and a world where everyone wears masks all the time is one with with much less coronavirus than one where no one except medical professionals wear them.

thank you for demonstrating the exact illusion of safety that's so pervasive around mask-wearing. no, masks are marginal, that's the point, they work at the margins.

it's the distancing that's doing the work of "much less coronavirus". for your statement to be relatively true, we'd need to live in a world with no lockdowns and no distancing.

Do you have a source for your claim that masks are less impactful than distancing?

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

> The findings of this systematic review and meta-analysis support physical distancing of 1 m or more and provide quantitative estimates for models and contact tracing to inform policy. Optimum use of face masks, respirators, and eye protection in public and health-care settings should be informed by these findings and contextual factors. Robust randomised trials are needed to better inform the evidence for these interventions, but this systematic appraisal of currently best available evidence might inform interim guidance.

This is clear: physical distance definitely works. Optimal use of masks might work -- that's all they can say, and they need better evidence.

Further down, under "Added value of this study," it says "Physical distancing of 1 m or more was associated with a much lower risk of infection, as was use of face masks (including N95 respirators or similar and surgical or similar masks [eg, 12–16-layer cotton or gauze masks]) and eye protection (eg, goggles or face shields)"

Yes, but that's a low certainty finding.

Low certainty * "large reduction in risk of infection" doesn't equal masks being marginal though, does it? (Not rhetorical, I'm an amateur at statistics) That means they need more data, but if an effect exists, it is large?

And I feel like we can reason about this to some extent from first principles - If the virus is spread through particles from faces, then face coverings will decrease the numbers of particles from faces that 1) get into the air and 2) get into peoples' faces, no matter how crappy the face coverings are. It seems more plausible to me that the problem is lack of data rather than incorrect conclusion, which seems like a reasonable interpretation of this particular study?

> a world where everyone wears masks all the time is one with with much less coronavirus

You don't know that.

You realize wide swaths of the global population use communal transportation in the form of trains, busses and subways? And then go to work in poorly ventilated factories or office buildings? I'm not sure what you intend as the solution other than nobody may ever leave the house again. Social distancing simply doesn't work when applied to everyday situations like this unless you find a way to get most people to opt out. Just working in the same office means a high risk of transmission despite whatever 1-3m distancing rule you want to instate.

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